We inspected this service on 5 and 7 December 2017. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults in and around Chesterfield. Not everyone using this service receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. There were 11 people receiving a service at the time of our inspection.

This announced inspection was carried out by one inspector and an expert by experience. The expert by experience had knowledge of care services including domiciliary services.

There was a registered manager in the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We rated this service as Requires Improvement in September 2016. Following this inspection, we asked the provider to complete an action plan by January 2017 to show what they would do to improve the key questions ‘Is this service safe, effective, and well led?’ to at least good. This was because we found quality monitoring systems were not always effective and systems were not in place medicines were safely administered; to ensure safeguarding was responded to and people’s capacity was assessed where concerns had been identified.

On this inspection we found improvements had been made although further improvements were needed with how quality was reviewed within the service, and checks were needed in the office to ensure it was safe. We have made a recommendation about the management of quality systems.

People felt safe when being supported. The staff knew how to protect people if they suspected they were at risk of abuse or harm and how to report concerns. Recruitment checks were made to confirm staff were of good character to work with people and sufficient staff were available to meet people's support needs.

Risks to people had been identified and staff understood how to support people to reduce risk and protect them from potential harm without restricting their rights. People had support plans which reflected their specific needs and preferences for how they wished to be cared for. We found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were able to make decisions about their care and staff knew how to respond if people no longer had capacity to make some specific decisions.

There was a small team of staff who had the skills to meet people’s needs. The support was flexible and responsive to changes. People received their care at a time they wanted it and they knew who would be providing their support. People were happy with how the staff provided care and were positive about the way staff treated them. People’s privacy and dignity were respected and upheld by the staff who supported them.

Risks to people’s health and wellbeing were assessed and plans were in place to monitor and to assist them in a safe manner. People felt comfortable raising any issues or concerns and there were arrangements in place to deal with people's complaints. People felt the staff had the right skills to provide the care they wanted.

People’s health needs were managed and the staff worked with health care professionals and helped people to attend appointments where necessary. When people required assistance to eat and drink, the provider ensured that this was planned to meet their preferences and assessed needs.

People had developed good relationships with staff and the registered manag

This inspection took place on 12 August 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk to staff and review records.

The service provides personal care and support to people who live in their homes in and around the Chesterfield area of Derbyshire. At the time of this inspection 24 people received support from the agency.

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service could not demonstrate all staff, including the registered manager, had maintained up to date skills and knowledge in areas relevant to people’s care and support, including safeguarding people and the Mental Capacity Act.

The provider did not have a policy in place on the Mental Capacity Act 2005 and records did not always show that people’s consent to their care and support was obtained in line with guidance.

In addition, other policies had not been up dated to reflect changes. The registered manager had not always sent through statutory notifications as required.

Evidence of audits and checks to ensure the quality and safety of services were not evident for all areas of service provision.

People told us staff were competent and well trained and staff we spoke with understood how to care for people effectively. Staff felt supported by the registered manager and had regular contact with them.

Staff understood how to support people with their nutrition and hydration needs. Staff were mindful of people’s healthcare needs and supported people to access other healthcare provision when required.

Staff spoke confidently about how to record administrations of people’s medicine. However, the provider did not provide medicine administration (MAR) charts as requested to assure us people received their medicines as prescribed. The medicines policy did not provide instructions to staff on how to record medicines administration.

Risks to people’s health and risks in their homes were identified and assessed in care plans with people. Staff recruitment and deployment was managed safely.

People were cared for by staff who were friendly and caring. Staff knew the people they supported and provided consistent and regular support to people. Staff supported people with their independence and promoted people’s dignity and privacy. People were involved in planning their care and support.

People knew how to raise any worries or concerns. People received personalised and responsive care and their views and preferences were respected.

The service promoted an open and inclusive culture. The registered manager demonstrated and open and inclusive style of leadership.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.